Assessment of Capsule Endoscopy Utilizing Capsocam Plus in Patients With Suspected Small Bowel Disease Including Pilot Study With Remote Access Patients During Pandemic

Models predict that the negative effects of delayed implementation in trachoma elimination programmes caused by the COVID-19 pandemic will be minimal, except in high prevalence districts where progress may be reversed During times of change we must stand by our principles of evidence-based decision-making, but also be willing to show flexibility Slow progress to elimination in high prevalence districts was already a significant challenge to the global programme and mitigation of COVID-related delays with enhanced implementation provides an opportunity to simultaneously address an unprecedented challenge and a pre-existing one The global trachoma elimination programme has made huge strides in the last 20 y with a large coalition of countries and partners putting the elimination targets tantalisingly within reach 1 The COVID-19 pandemic has affected every person on the planet and disrupted service delivery on a scale previously unimaginable There is clearly anxiety that halting implementation will cause a loss of momentum, or even reverse the trajectory of the programme The modelling papers by Borlase et al 2 and Blumberg et al 3 in this supplement are a very welcome contribution to the literature The pandemic has brought novel challenges, but also exposed and amplified pre-existing challenges to trachoma elimination Three of these are how to (1) enhance implementation activities in high prevalence districts that respond slowly to the normal implementation pressure, 4 (2) resolve the conflict between the allocation of time, money and human resources to conducting surveys rather than implementing control activities 5 and (3) conduct at-scale hygiene promotion programmes This commentary focuses on the first two of these pre-existing challenges in the context of COVID-19